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evw writes "The Wall Street Journal reports that Steve Jobs had a liver transplant two months ago (subscription required, alternative coverage is available based on the WSJ's report). He is on track to return to work at the end of June. 'William Hawkins, a doctor specializing in pancreatic and gastrointestinal surgery at Washington University in St. Louis, Mo., said that the type of slow-growing pancreatic tumor Mr. Jobs had will commonly metastasize in another organ during a patient's lifetime, and that the organ is usually the liver. ... Having the procedure done in Tennessee makes sense because its list of patients waiting for transplants is shorter than in many other states.' There are no residency requirements for transplants."

Unless Jobsy himself has told you this, I'm pretty sure that running this article either violates HIPPA, or is simply full of lies...

Where did the information about a transplant come from? I hope the source was verified, and re-verified, and then re-verified again. Remember when CNN posted that Jobs had had a heart attack, but it simply turned out to be "citizen journalism" gone horribly, horribly wrong? Gotta be careful with this crap.

"So, is it bad if he uses that money to get the kind of treatment you and I can't afford?"

Always an interesting question. I would say yes, it is a bad thing. Not for Steve of course, but for what it represents.

Steve Jobs has large wads of cash as that is what we give people who prove themselves to be great assets to the economic system. No doubt, Steve Jobs is exactly that, but should your value to the economic system be the primary factor behind the level of medical care you receive? I would say no. Steve Jobs has no more right to the best standard of care than does somebody who has been in the police force, or a teacher (for example) their entire lives. In fact, I would say that anybody who has lived a moral, decent life should receive the same level of medical care, and that should be the highest available at the time. The only people that I would say might not deserve this are serious/career criminals.

It is easy to get confused in this matter because we are talking about Steve Jobs, who seems a pretty smart and decent guy anyway. How about if we replace Steve with Ken Lay, should 'Kenny Boy' receive a much higher level of medical care than somebody who choose to be a librarian rather than a 'business tycoon'?

You can probably guess I one of those evil socialist types;o), but I come from a country where we have socialised medicine. It is certainly not perfect, but I don't believe that is a fault with the system, but a fault with the people running it.

I tend to go even further: Even criminals, who in your opinion don't deserve that, should enjoy equal medical treatment. We send them in jail for what they've done, but when everyone else would get the same medical treatment, denying it to them would be a cruel and excessive punishment.

In fact, I would say that anybody who has lived a moral, decent life should receive the same level of medical care, and that should be the highest available at the time.

What if the best medical care possible is very, very expensive? Like, for a sci-fi example, a drug made from atoms of antimatter trapped inside buckyballs. The buckyballs are tagged with proteins to stick to cancer cells, then an electromagnetic pulse cracks them open, releases the antimatter, and POOF - no more cancer.

Suppose that making the antimatter requires a $5 billion dollar facility that needs $100 million dollars of energy to make enough for one patient. There's not enough money, energy, or scientists on Earth to make enough to treat everybody with cancer.

Should we deny a billionaire cancer patient the freedom to buy his own dose from a multibillion pharmaceutical company that invested in such a facility for the small but profitable segment of the population that can afford such a drug?

This is the crux of the issue. a) that somehow medical treatment is totally different than any other service/commodity (it's not) and b) that we should be force at gunpoint to pay for every unhealthy
clown on the planet because of their bad choices.

If i want a better house, I earn more money so I can buy it. Ditto with a car. Want a better education? Pay for it. That's how the world works.

As for the second point, all you need to do is work at the ER in a major hospital for a while to see what happen when you give people free medical care. All the welfare grabbing losers who are already sucking on the government teat like that was no tomorrow show up for the most trivial reasons you can imagine, just because it won't cost them anything. Things that any normal person would either self treat of see their doctor in the morning. I'm not kidding, I saw a guy arrive once in an ambulance because he ate something that gave him gas. Think of how many thousand dollars that cost the taxpayers.

So if any of these [dekalbmugs.com] people or these people [gwinnettmugs.com] need a liver transplant, they should be front and center in line to get a brand new liver, well ahead of a supportive member of society that regularly pays his contribution to society? That's 2 counties out of 3140 in the US and those are people arrested on a Friday night.

Socialized medicine in the US will never work as it's intended because the gap between the haves and the have nots and the gap between the dos and the do nots will widen contributing to an apathetic society. The do nots will get the care ahead of the dos and drain the system and the haves will get the better care that the have nots will complain about. The people that will end up getting screwed will be the average Joe wanting this "everyone's covered" plan that does his contribution to society. What's the point of being a 'do' if the 'do nots' get all the same benefits? If you want to be a doctor to treat the 'haves' but the law states that you have to treat the 'have nots', what's the point of becoming a doctor? Doctors will not get paid competitively in a monopolized payment structure.

If you're going to grow a vegetable garden for yourself, you need to prepare a method for dealing with rabbits. (If I have to explain that, you will never get it)

Now, in the same vein, the current 3rd party payment system needs to be radically overhauled but that is a beast that is "too large to fail."

If the government stayed away from subsidizing education, the prices for it would go down and more people would be able to afford it in the first place. More doctors would graduate and that would drive their prices down so even a private health system could be affordable.

Wrong. This is pretty much the same as saying that when the goverment wouldn't subsidise car manufacturers, everyone could afford a Porsche.

A private education system, same as a private healthcare system, will charge for the services whatever the market can bear. That means for healthcare that the doctors will charge real shitloads of money. Just because they can - if people are seriously ill, they'll pay any cost to get healthy again. Those, who cannot afford to pay that huge sums of money would receive no healthcare - thre is no reason doctors would waste their time for the poor when they can use the time to treat wealthy patients. Everyone else would have to pray to their personal deity or to resort to traditional medicine (which is also pretty costly these days since there aren't that many places anymore where you can harvest herbs).Same would happen to education.

I believe on economy my position is logical and yours is not.

Nope, your position is illogical because it is based on beliefs. In other words, economy is a religion for you.

What I describe are just facts. We have already had fully private education and fully private medicine. There is a good reason why 20th century has changed that.

What's the point of being a 'do' if the 'do nots' get all the same benefits?

What's being suggested is all the same HEALTH benefits. The answer is of course that people "do" for a mixture of reasons possibly including getting paid and enjoying it. You don't need to bribe people with their health to get them to "do".

Conversely, punishing the poor with third rate or none existent healthcare, as you already do, has done nothing whatsoever to solve the problem you highlight, has it? Look at this list of recent unemployment rates. America is mid table amongst other countries that have "socialized" healthcare.

If you're going to grow a vegetable garden for yourself, you need to prepare a method for dealing with rabbits. (If I have to explain that, you will never get it)

No, it doesn't need any explaining at all. You cast some people are vermin that don't deserve healthcare. Your analogy contains no possibility of any such vermin proving themselves worthy of healthcare. Your analogy casts people as vermin from birth to death, with no possibility of change. Or possibly, just possibly, your analogy that you thought unquestionable was a little silly.

If you want to be a doctor to treat the 'haves' but the law states that you have to treat the 'have nots', what's the point of becoming a doctor?

That rather reveals that you don't know enough about "socialized" medicine to be passing any comment at all. Most countries that have "socialized" medicine don't make private medicine illegal.

Question: Why aren't you campaigning to get rid of the "socialized" fire service, "socialized" highways, and "socialized" police services you already have. Surely according to your line of thinking they will never work.

While HIPAA (note the correct spelling) restricts employees of the hospital from divulging any of this information without Jobs' consent, there are certainly other people who could have known about the transplant, and then provided this information to the Wall Street Urinal without violating it. Friends, family, neighbors, the FedEx guy, the limo driver, Steve's certainly-overpaid hairdresser, an iStalker, the florist who delivered a bouquet of apple blossoms with a note reading "an Apple® a day keeps liver transplant rejection away", etc. are not bound by HIPAA. Neither is any newspaper or web site that subsequently publishes the info. With any of these, there might conceivably be some grounds for a privacy suit under some other statute, but HIPAA ain't it.

Sometimes the only way for a journalist to obtain the information they need from reliable sources is to promise to keep their sources anonymous. It's particularly funny that you are picking on the WSJ because they are the paper that brought down Nixon with information from anonymous sources.

Er, poor Americans run to Canada, rich Canadians run to America. Not saying that there's anything wrong with the Canadian system, it's just human nature to do the best you can when your health is on the line. And if you've got tons of cash to blow, the US has got great doctors for you.

But when such a society treats the most despised better than they treat the most valued, what does that say about how they understand value? There are millions of disenfranchised working poor who cannot get medical treatment that prisoners in jail get simply by being incarcerated. If you can advance the constitutional rights of criminals, why is it that such arguments are not made for those who are financially imprisoned?

I think the issue is there is a lack of understanding of the difference between good government and bad government. Good government minimizes risk for its people; bad government increases risk. With healthcare, a good approach for government would be to minimize risk for honest providers and minimize the risk for honest people trying to obtain or keep healthcare. Good solutions more often than not aren't purely socialistic or capitalistic, they're common sense.

So if any of these [dekalbmugs.com] people or these people [gwinnettmugs.com] need a liver transplant, they should be front and center in line to get a brand new liver, well ahead of a supportive member of society that regularly pays his contribution to society? That's 2 counties out of 3140 in the US and those are people arrested on a Friday night.

Health care is not the method to settle this. If you don't think people coming out of jail will be productive members of society, suggest fixing the jails so they will. That's what they're there for, aren't they?

If you think basic human rights should not apply to everyone, then expansion of the death sentence is the answer for you. But judging people based on their mugshots is just plain wrong. How many of those look mean only because they just got beat up by a cop having a bad day? Here's one particularly mean fella:

MIGUEL VIGUERAS-GUTIERREZPOWDER SPRINGS RDMARIETTA GA 30064

Admitted: 2009-06-19 22:42:00

Charges: M/V MUST HAVE 2 HEADLIGHTSPARKING ON ROADWAYNO DRIVERS LICENSE

So if any of these [dekalbmugs.com] people or these people [gwinnettmugs.com] need a liver transplant, they should be front and center in line to get a brand new liver, well ahead of a supportive member of society that regularly pays his contribution to society? That's 2 counties out of 3140 in the US and those are people arrested on a Friday night.

I wouldn't say they should be ahead of anyone else... But they shouldn't be put to the end of the line or excluded just because they happened to be arrested. What, you do something stupid and you're not allowed to live?

Socialized medicine in the US will never work as it's intended because the gap between the haves and the have nots and the gap between the dos and the do nots will widen contributing to an apathetic society.

Look around the world at the countries that have nationwide, universal healthcare. They don't seem to be doing too bad...

The do nots will get the care ahead of the dos and drain the system and the haves will get the better care that the have nots will complain about.

So... If the government is paying for it the healthcare will automatically go to the poor first? I don't recall seeing that in any of the plans... Most of the time you've got a waiting list for organ transplants - organized by how close to death someone is, and then by how long they've been on the list - I certainly hope finances doesn't enter into it...

The people that will end up getting screwed will be the average Joe wanting this "everyone's covered" plan that does his contribution to society.

Right. Because the average Joe is doing so well under the current system...

What's the point of being a 'do' if the 'do nots' get all the same benefits?

It is certainly true that benefits enters into the decision making process... If I've got my choice of two jobs, and one of them has better benefits, I'll probably take that one. But it isn't like I'm going to switch careers just for the benefits. Nor am I going to put up with a horrible job just for the benefits. Nor would I be sitting on my ass in poverty just because I had healthcare. People do for a variety of reasons.

If you want to be a doctor to treat the 'haves' but the law states that you have to treat the 'have nots', what's the point of becoming a doctor?

One would assume that you could still specialize and have some choice in the kind of medicine you practice... If you really wanted to be a gynecologist you probably wouldn't be forced into proctology. Or did you mean you just wanted to discriminate against your patients? Only treat the wealthy? Only treat whites? Only treat beautiful women?

Doctors will not get paid competitively in a monopolized payment structure.

I guess I'd rather my doctor was doing it for some reason other than pure money. I'd like to think that my doctor wanted to make people healthy... Or enjoyed the work... Or something like that... I know that in IT the folks who are passionate about their work are usually superior to those who're just showing up for a paycheck.

If you're going to grow a vegetable garden for yourself, you need to prepare a method for dealing with rabbits. (If I have to explain that, you will never get it)

No, you don't need to explain. Your views are more clear, perhaps, than you realize. You've just cast anyone who is not able to afford their own healthcare as nothing more than vermin - to be dealt with accordingly.

Must be great for Jobs, who has probably never before set foot in Tennessee in his life. Meanwhile, all the other transplant waiting list patients around the country, who either cannot afford the trip to Tennessee, or whose insurance won't pay for organ transportation, they can spent an extra eight months waiting...

So if any of these [dekalbmugs.com] people or these people [gwinnettmugs.com] need a liver transplant, they should be front and center in line to get a brand new liver, well ahead of a supportive member of society that regularly pays his contribution to society?

Strawman. No one is suggesting elevating them to a higher status and pushing them to the front. What we're saying is that being arrested for shoplifting, DUI, or driving on a suspended license should not get you kicked from the "first come, first served, weighted for urgency" organ transplant list.

Question: Why aren't you campaigning to get rid of the "socialized" fire service, "socialized" highways, and "socialized" police services you already have. Surely according to your line of thinking they will never work.

This is actually an interesting question and while I don't know that I have a specific answer, if you ever have to deal with any of these three systems directly you know what a mess they are. Police and road work are easy to pick on.

Few people with a brain think, "Wow, those boys in blue do nothing but protect the innocent and save lives. They always tell the truth and never pull anyone over just to increase state revenue." And I've never been anywhere in the USA where people say, "Man, the road work here is done in such a well thought out manner and they're not constantly ripping things up over and over again and they're always on schedule." Corruption and greased palms go hand in hand with everything the government pays for--this includes the FEW things I think the government ought to pay for. So, even for someone like me (who is very much opposed to socializing most things), you're right that there are some things meet a certain threshold where they're good that the government pays for them.

Those aside though, I want to point out something that 2.5 of those have that most people proposing socialized medicine advocates generally don't advocate: local control. I don't have federal police officers or federal firemen and although there are SOME (this is the 2.5 deal) federal highways, a majority of the roads are handled by the state and county, not by the federal government. This gives locals more control and, in theory, leads to higher accountability to the people directly.

I would be much more willing to consider some kind of socialized medicine IF it was at a state level with no federal strings attached.

However, socializing medicine is a government "solution" to a government "problem" and the problem of corrupt medical and pharmaceutical companies. It's a way to get the government to pay for the excessive costs and fees being pushed out by the medical industry in general rather than dealing with the problem of what is, more or less, a price fixed quasi-monopoly. So now you have the government paying into these companies and with that kind of money they buy all the government they need to keep their cartel going. At least if it's localized there's a competitive market of sorts among the states rather than a big fat stupid bloated contract from the feds.

Health care in this country is broken and I have to say, it wasn't always broken. When my grandfather was born a stay in the hospital (and I have the bill) for his mother including all the delivery and care and everything came to a wooping $28. While inflation accounts for some of the disparity in costs, think of how much a week's stay would cost now without insurance. Why has the cost risen so much?

That's the real problem with healthcare. Instead of just saying, "No one can afford it, the government needs to pay for it..." no one seems to be asking, "Why can't people afford it?" The generations before my parents, my grandparents and up managed to be healthy and afford their doctors on the wages of working men and women. What's changed?

The answer is not as simply "do we socialize or not socialize?"

And it's not just the medical industry either. It's the American lifestyle. Healthcare is about surgery and pills and not about taking care of yourself. All one has to do is look at the rise of obesity here. My mom was on what seemed like 100 medications for multiple sclerosis for years. She was living in a state of just... numbness. More or less, one day she had an epiphany of sorts and changed her diet, started exercising regularly, lost 100ish pounds over the course of 16 months and now is on no meds, has stable blood pressure and is doing better than she's done in her entire life.

Should me or my neighbors have been forced to pay for someone like my mom

a) With socialized medicine the doctor tends to get paid about the same anyway, so it's more likely he'd try to do his best for the patient given the limits of the hospital and the health care budget.

b) With private health care where the patient is paying most of the bills (and the boss), the doctor will do his best for the patient given the limits of the hospital and the patient's budget.

c) With private health care where Insurance Companies are the paymasters, the doctor may encounter some conflicts between what's best for the patient and what's best for the Insurance Company.

So:With b) even though it's about profit, it the patient tends to get the best the patient can afford.With a) the patient gets the best the Government can afford to give to the average person (or more if the country goes into debt;) ).With c) the patient gets the best of what the Insurance Company is willing to pay, which not surprisingly can often be worse than a) or even b).

That's incredibly insightful.. it is astounding to see the number of people who think that healthcare is a right when it objectively is not a right and can never be a right... and that is not my opinion but an objective fact. A "right" is only a protection from other people curtailing your own freedoms. Your right to free speech is a protection against others preventing you from speaking, your second amendment right to bear arms is a protection from the government banning you from lawfully owning firearms. However, a right NEVER entitles you to be given anything. My first amendment right does not entitle me to be given free airtime to rant at society and my second amendment right does not entitle me to steal guns.

Anyone who claims to have a "right" to healthcare does not actually believe in the constitution because the 13th amendment outlawed slavery. If you expect to enslave doctors and society in general for the simple reason that you got sick, then not only are you guaranteeing that the already heavily-socialized medical system will become even worse, but you also have no respect for real "human rights".

He shopped around, discovered that the state of Tennessee could best meet his needs, and took his business there. It's called a free market. It's kinda nice, really...

Are you suggesting only people Tennessee be allowed to buy products and services from Tennessee? I doubt the people of Tennessee would agree with that. Are you suggesting people from California not be allowed to buy products and services from outside California? The "buy local" people might like that, but I don't think that's really a good idea either...

Money is pissed away by DOD like you wouldn't believe. I shudder sometimes at the huge amounts of money I see foolishly wasted...with no repercussions to the people who made the bad decisions. In fact often the most ineffective managers get the most promotions and awards.

I've seen the same kind of inefficiency, waste, and idiotic management... in large corporations. What you're talking about is not a feature of public vs. private sector, it's a feature of large vs. small. The exact same kind of bureaucracy, inefficiency, etc. infects any organization once is surpasses a certain size.

I think everyone sees fire and police service as best handled by government. I think the reasons are obvious. The problem with government run health care is that it isn't as obvious a solution to everyone as it is to you.

The reason public run fire and police makes sense to you and public run healthcare doesn't is because that's the way it happens to be organised at the moment in your country. It's easy for me to envisage government run healthcare because I've seen it in my country. It's just as "obvious" as fire service, police, schools and highways to most people who have experience of it. The couple of American ex-pats I know that live in Britain don't need any more convincing. They know it's a better system than the one they grew up with.

how is it even legal to prevent a professional to provide his/her services for the best payment if he wants that extra money? I am a software developer working on contracts,...

There is no licensing and not much regulation on writing software, so you can do pretty much whatever you want. As a programmer (like me), you are a professional in the broad sense that you write software for a living, but not in the narrower sense of being in one of a few distinguished occupations (traditionally doctor, lawyer, dentist, architect, and a couple others) for which you are required to hold a government license and follow a lot of regulations and ethical requirements that we programmers don't have to deal with. You get a bunch of respect/recognition and basically automatic income in those professions, and you give up some freedom.

Heck, let's say you're in the army and you work as a sniper. That's fine, it's an honorable military specialty and you're a soldier working under the strict instructions of the government. Try to do the same thing as a private business and you're a "hit man", hopefully attracting the obvious response from law enforcement.

People in the medical business are in a highly regulated trade doing stuff that regular people are not allowed to do. If you're trying to go libertarian on me, first let us all start making and/or buying whatever medications we want without needing prescriptions. We can talk about widening doctors' rights to sell their services to whoever they please AFTER you've arranged that first part. Until that happens, they're like snipers in doing what the rest of us are not allowed to do, so they don't get as wide a range of choices about who to do it for.

" You have to understand that these people also belong to the same party that opposes teaching evolution and as such, they're immune to evidence, so pointing out that the facts fly in their faces really has no impact on there opinions..."

Thank you for your unbiased, well-reasoned addition to this conversation.

He shopped around, discovered that the state of Tennessee could best meet his needs, and took his business there. It's called a free market.

I don't think, in any way whatsoever, that the market for liver transplants should be a free market.

It's kinda nice, really...

It's not "kinda nice, really", it's fucking disgusting. I don't really blame Jobs for going to where the livers are, but the system which allows such inequalities to exist in the first place.

Are you suggesting only people Tennessee be allowed to buy products and services from Tennessee? I doubt the people of Tennessee would agree with that. Are you suggesting people from California not be allowed to buy products and services from outside California? The "buy local" people might like that, but I don't think that's really a good idea either...

How do you get from there (livers) to here (general "products and services")? The context is scarce, life-saving organs. We're not talking about produce or iPods, we're talking about people's lives.

I'm sure Steve Jobs can also afford a much better car or house than you can, too. Do you also think you're entitled to a Porsche and a mansion because you're risking more of your life to pay for your house and car?

If your country has socialized medicine; then I'm guessing that people go OUTSIDE the system (or even the country) to get the best care possible.

In case you didn't know, all countries except the US and South Africa classified by the UN as industrialized countries have socialized medicine. For some reason, I don't think that the statistics show (life expectancy, birth survival rates, etc.) that the US is the only industrialized country with decent health care.

Nor do I think that all people who seek better health care, go to the US, or South Africa, in order to get health care that is better because the poor can't afford it. I wonder at the moderator's judgement how you got modded up to "5, insightful". It should be "5, doesn't know the world outside of the US borders".